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viagra vs. injections vs. the pump. Help!

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cowboy bob
Regular Member
Joined : Sep 2007
Posts : 116
Posted 8/24/2009 6:40 AM (GMT -8)

I had my prostate removed two years ago and am still dealing with the sex issue. Viagra gets me about 2/3 there, and, using proper timing, my wife and I can "kind of" get it done. My doctor said the next step would be injections. Anyone have any success with those, or with a vacuum pump?

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Mavica
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Joined : Jun 2008
Posts : 407
Posted 8/24/2009 6:48 AM (GMT -8)
What type of "injections" are you making reference to?
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cowboy bob
Regular Member
Joined : Sep 2007
Posts : 116
Posted 8/24/2009 7:17 AM (GMT -8)
The kind where you stick a needle in your penis and inject erection medicine.
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goodlife
Veteran Member
Joined : May 2009
Posts : 2692
Posted 8/24/2009 7:53 AM (GMT -8)
If you are 2/3 there, then the stick the needle in your penis ought to work like a charm with a relatively low dose. What strength Viagara are you taking ? Could be a higher dose ( if not 100 now ) could help. Other question is have you tried Cialis or levitra ? Some guys seem to have better success with on eof the other brands.
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CPA
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Joined : Feb 2008
Posts : 655
Posted 8/24/2009 8:45 AM (GMT -8)
Greetings, Cowboy Bob.  I have not had to use injections, but guys here swear by them.  I would echo a couple of other comments - look at the Viagara dosage you are using and if it is not 100, ask your doc about using maximum strength.  Also, while I haven't tried any form of Viagara, both Levitra and Cialis work for me.  You might also ask your doc about trying one of the other meds.  David

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lifeguyd
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Joined : Jul 2006
Posts : 691
Posted 8/24/2009 8:51 AM (GMT -8)

cowboy bob said...

I had my prostate removed two years ago and am still dealing with the sex issue. Viagra gets me about 2/3 there, and, using proper timing, my wife and I can "kind of" get it done. My doctor said the next step would be injections. Anyone have any success with those, or with a vacuum pump?

Bob, I use bi-mix injections.  They work great and are no big deal.  There are dozens of discussions on this forum about injections, do a search (above) and read some of them.  I have not found the pump to be very good for intercourse, but it does help rehab.

https://www.healingwell.com/community/default.aspx?f=35&m=1412483

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Ed C. (Old67)
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Joined : Jan 2009
Posts : 2543
Posted 8/24/2009 11:18 AM (GMT -8)
Bob,
I use trimix injections and it works fine for me. If you are planning on going that route I suggest that you us the 31 gs needle, it is painless. Make sure you start with a low dosage like .1 ml and increase it the next day if it doesn't work.
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Mack Allen5
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Joined : Aug 2009
Posts : 2
Posted 8/24/2009 1:39 PM (GMT -8)
DIRTY ROTTEN SPAMMER alert- PLEASE IGNORE
I would recommend you to try cialis instead of using injection. I stopped using viagra as it made my flush so I switched to cialis which works better but I then switched to the generic version of it from DIRTYROTTENSPAMMERWEBSITELINKDELETED

Post Edited By Moderator (James C.) : 8/24/2009 4:07:36 PM (GMT-6)

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cowboy bob
Regular Member
Joined : Sep 2007
Posts : 116
Posted 8/24/2009 8:04 PM (GMT -8)
Thank you all. I have been taking the max (100 mg.) when it comes to Viagra. I have also tried Cialis and Levitra, but Viagra seems to work the best. I do believe I will try the injections. Just hope they are not too expensive. I'm paying $16 per pill for the Viagra.
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James C.
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Joined : Aug 2007
Posts : 4464
Posted 8/25/2009 5:35 AM (GMT -8)
cowboy bob, my Trimix injections, compounded locally at a Medicine Shoppe pharmacy is $97 for a 10ml vial. Averaging dose is .1ml for most of the guys, so you get 100 dose, or cost of $1.00 a shot. My Bimix is $54.00 per 10ml vial, and using a dose of .3ml, the figures are 33 doses costing 1.64 each.

I figure you know about www.alldaychemist.com, so won't go into that here, other than to say generic viagra at .54 a pill plus $24.95 any size package shipping.
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FiftiesMale
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Joined : Mar 2009
Posts : 75
Posted 8/25/2009 7:56 AM (GMT -8)
All who have used injections,

Several weeks ago, I read some post by a guy who said something about having to go to the hospital due to an extreme priapism (something about having to have his penis drained). I assumed that he was honest in his post. After reading it, i have been totally afraid of considering any type of injection. However, i see many people (here) posting about using it, and on a regular basis. Can you provide some minimal additional details? I am guessing that i would need to get pre-approval, and a subscription via my Urologist, before i can obtain one? Or, is there the possibility of using "alternate" sources (like ADC) to obtain some. After reading the scary post, i think i would not want to try it without consulting my urologist. However, many of you use the injections on a regular basis. I am quite interested to hear more. At the moment, i can't imagine sticking a needle into that part of me. Yet, I am trying many other methods (viagra, cialis, levtra, and a pump). So, maybe i need to consider this as well. What area do you put the needle into (top, shaft, etc)?. How far in does the needle go? How painful is "not too painful"? How quickly do the results occur? and how long does the result last? Can you, or do you, combine the needle with other things (pills, pump, etc.) or is it more of a "needle only" due to how complete the results are? and what type of injections are preferred (seems like i have seen a few different names/brands "trimix" and others).

thanks
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James C.
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Joined : Aug 2007
Posts : 4464
Posted 8/25/2009 9:19 AM (GMT -8)
Injection drugs are obtained by a doctors prescription and must be filled by a specialized pharmacy- an compounding pharmacy- which mixes the drugs to be used. There are 3 types of drugs- Caverject (alprostadil), Bimix and Trimix. Alprostadil is a a single drug, bimix is a mixture of papaverine and phentolamine, usually in the strengths of 30mg papaverine/1mg phentolamine when written on the prescription. Trimix is the same as bimix, with the addition of alprostadil to it, and usually written as 30mg/1mg/20mcg, the 20mcg being the alprostadil. In listing strengths, the alprostadil is the strongest and seems to obtain the most effective result. It is also the most expensive and lots of guys have problems with both aching, pains and piraprisms (SP)- erections of longer than 4 hours. Trimix is the next strongest and results in very good erections, with much less chance of the aching/pain and the 4 hour hour erections. Bimix is the llowest strength of the 3 , but seldom gives the aching/pain or the 4 hour erections. Dosing sizes of Trimix is usually much less than Bimix, so it takes much less to get the same result, however it does seem to have a chance of giving more troubles with aching/pain and the problem erections.

Most doctors will begin the injection treatment with Caverject (alprostadil) injected in the office to get a baseline of what is needed and to teach the man how to inject. Some men have a bad experience with this, as the alprostadil is usually injected at a much higher dose than needed, which creates the aching/pain and the over 4 hours erections which we hear about once in a while. It seems doctors have a set formula of what they are taught to inject and that isn't always the best. If it works in the office, he will usually send the patient home with a prescription for alprostadil and further instruction on how to use it. It seems that most doctors don't begin with Trimix or Bimix, unless they are dealing with an educated patient who can ask for, explain why, and can advocate for themselves trying something different. I am fortunate to have a doc who will deal with me on an equal basis and is willing to try what I suggest with different ratios of strengths to dial it in for me. I feel that a man who is starting injection therapy should begin with either Trimix or Bimix, rather than alprostadil, as the chances of a ache/pain free experience will have him much more willing to continue. The physical act of injecting is simply pain free for me now, but it took quite a bit of repetition and experimenting to reach this state. Once a guy begins injecting, he needs to keep at it, experimenting and dialing in what he needs to get the best results with the least amount of drug or trouble.

As far as technique, its simple, actually. Use the least diameter needle, usually a 5/16" 31 ga. insulin syringe, and inject into the penis midway between the head of the penis and the body, at the 9 or 3 o'clock position. A little milking motion of the penis will help open the cavernous cavities a little, so the drug cane be deposited into the space. A little massage and the erection should begin, usually within 5 to 10 minutes, and if enough drug is injected and adsorbed, results in a penis erect for an hour or so. That's the idea goal. It can vary. Done right, with practice, the injection can and will be painless for most guys. There's no reason to think you would be any different. I don't combine by injections with other items such as pills or pump, but some here do.

Yes, once in a while we will have guys here have a bad experience, resulting in a 4 hour erection and a trip to the hospital or doctors office. It's traumatic, of course, but frankly still part of the risk of using injections. The draining of the penis blood was sorta overkill, IMO, usually the penis is injected with epenephrine(SP) or such, which counteracts the penile injection drug. I have only had one over 4 hour erection, I relieved it with Sufafed, rathert than a hospital visit. That was the first time I self-injected, it was alprostadil and it was the doctors recommended dose, which was 3 times more than I found I needed.

There's several excellant websites with great instructions on the process, and we can look at them later, when you are ready to start the injections.

This is a general overview of the process, stressing they general or average, or normal process and results by the majority of the guys here, to give you a general look at the normal experience and answers to your questions.

Here's a couple link to a post that will contain some research info for you to continue your study:
www.healingwell.com/community/default.aspx?f=35&m=1347869&p=1
www.healingwell.com/community/default.aspx?f=35&m=897291
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FiftiesMale
Regular Member
Joined : Mar 2009
Posts : 75
Posted 8/25/2009 9:51 AM (GMT -8)
Thank you, for the very complete information. I will need to do some studying, and ultimately check with my urologist for any approval.

thanks again.
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cowboy bob
Regular Member
Joined : Sep 2007
Posts : 116
Posted 8/25/2009 5:31 PM (GMT -8)
Yes, great information. Thank you!
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Piano
Veteran Member
Joined : Apr 2008
Posts : 847
Posted 8/25/2009 8:02 PM (GMT -8)
It's hard to improve on James C's excellent post, but I will say this:

Most doctors don't know very much about ED or injections -- that is why they frequently start with the expensive Caverject at too high a dose. Overdosing leads to priapism.

To avoid this, I suggest start with a lower dose than you think you need and work your way up. And as James suggests, keep some Sudafed on hand just in case. Once you have discovered the drugs and dosage that works for you, priapism should not be a problem.

Other techniques that may help to give consistently reliable injections (discussed in other threads here) and so avoid priapism are:
1. Pre-plumping
2. Using a constriction ring while injecting (my favorite)
3. Standing while massaging (raises the blood pressure)
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cowboy bob
Regular Member
Joined : Sep 2007
Posts : 116
Posted 8/26/2009 3:35 AM (GMT -8)

Piano,

Good to hear you are doing well with this seeing as how you had non-nerve sparing surgery.

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Tamu
Veteran Member
Joined : Oct 2006
Posts : 626
Posted 8/26/2009 6:36 AM (GMT -8)
Just to add to the thread the compounded injections can be customized.  As an example, I am one of those that had severe aching with Alprostadil.  I started using Bimix.  While it provided a good enough erection for sex it was just not as firm as I would like.  Raising the dosage up did not give me any firmer an erection just one lasting longer.  I read here on the forum where one of the members went to Trimix with a smaller portion of Alprostadil.  I got a prescription from my urologist for 30mg papaverine/1mg phentolamine/2.5 mcg prostaglandin(Alprostadil).  The normal formula for Trimix has 10 mcg prostaglandin.  This customized formula works well for me.  My dosage is 0.05 ml.  The erection still lasts longer then I would like at 2 to 3 hours but when I reduce the dosage I lose the erection. 

Tamu

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Romeo
Regular Member
Joined : Aug 2009
Posts : 23
Posted 8/26/2009 9:30 AM (GMT -8)

Hello there Cowboy Bob,

I am the guy who had to go to the hospital with an erection which lasted over 4 hours and hurt.  Actually it last about 6 before they drained the blood out and injected my penis with drugs which caused it to go down.  The reason they need to get the blood out by draining is because it can form blood clots and damage your penis.  I may have made a mistake and injected myself with .3 rather than the minimum .1.  It was the first time I did it and my doctor did the injecting and made the recommendation.  I was very close to achieveing a full erection by taking levitra before this and I believe that the .3 was to much or more than needed.  subsequent to this episode I am now about able to achieve full erections which get better each time using levitra 20mg.  I have tried Cialis (minimal help) and Cialis and it causes me to flush a lot and gives me a headache.  Levitra works real well for me but I was surprised when I saw that several of the posters said they had been taking 100 mg because my doctor told me that 20mg was the highest dosage and that no trials suggested that a dosage higher than that did any good so I would be interested in hearing more about peoples successes with 100mg because if my 20mg is working real good for me then the 100mg might be perfect for me. 

If you do try the injections and I suggest you do I would start with the very minimum dosage and go forward from there.  In addition, I found out later that it is a good idea to have sudafed with you as if your erection stays to long it will help reduce it.

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wd40
Regular Member
Joined : Jan 2008
Posts : 218
Posted 8/26/2009 12:38 PM (GMT -8)
Just to add a bit. Keep in mind what you eat and drink has a big effect on how the pills work. A big meal, or alcohol is just not good when using pills. Also try sex in the morning.

I have good luck using just the rings to hold everything in when using the pills
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FiftiesMale
Regular Member
Joined : Mar 2009
Posts : 75
Posted 8/27/2009 10:23 AM (GMT -8)
I appreciate the many good posts.

If i do go forward with the injections, i will definitely go through my Urologist/Surgeon's office. I am curious though, are the injection materials also available through the ADC website. I have tried the Viagra substitute through that website. I am not certain if it works the same as the real Viagra (since my results with real Viagra have been mixed, sometimes better than other times, but none of the times really being firm enough for true penetration). I can barely get penetration when i am on top.

My wife misses being on top. And, unfortunately, when I am on the bottom, it is the worst position in terms of blood loss due to gravity (if you know what i mean). It really requires true erection in that position. Therefore, i am giving thought to the injections.

One more question. To those guys who have regained natural erections. Are they close to pre-surgery? Or at least, are they close enough to facilitate penetration (with being on the top, missionary, and being on the bottom).
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James C.
Veteran Member
Joined : Aug 2007
Posts : 4464
Posted 8/27/2009 11:02 AM (GMT -8)
No, the drug is not available thru ADC. It is a temperature and time sensitive drug, and must be kept chilled, shipped chilled and usually overnight delivery, if ordered from the most commonly used Compounding Pharmacy in the US, at least as used by our guys here. That's Franck's Pharmacy. There's usually a 90 day life date on it, but mine has lasted up to 8 months with little drop in effectiveness.

/secure.francks.com/?action=h_ordering_options

You may have a local branch of the Medicine Shoppe Pharmacy chain, lots of them have compounding labs in store, or there may be other pharmacies locally who can do the compounding. Your prescribing doc may know.

Here's the link to another thread listing the ones used by the guys here.

www.healingwell.com/community/default.aspx?f=35&m=1017774
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TKKNZ_GRANDPA
New Member
Joined : Sep 2009
Posts : 2
Posted 9/4/2009 8:44 AM (GMT -8)
This forum gave me the confidence to seek use of the injection. Saw the Physician Assistant yesterday for the first injection. Took about an 45 minutes to get a good firm erection and it lasted about an hour. Did not try intercourse since this was the first experiment. It was 0.3 as suggested by the PA. Also got samples with .5 and .75 to try at home. Had to get over my male ego to try the injection because the pump was too cumbersome and Viagra/Cialis were not giving satisfactory erection. Am anxiously awaiting opportunity to "try for real". Nothing has been going on in that department since late 2007 so I AM READY!!!

I did have a little experience giving myself an injection after hip replacement surgery (drug to prevent blood clots) so I did have that in my favor before I tried injecting the drug into my penis. Had a very little burning sensation for about 30 seconds after the injection. After that I just waited for the drug to work - which it did!

I will post later with, hopefully, success.
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MrGimpy
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Joined : Jul 2009
Posts : 504
Posted 9/4/2009 11:14 AM (GMT -8)
.3 then .5 then .75 samples, what is it they gave you ?
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Romeo
Regular Member
Joined : Aug 2009
Posts : 23
Posted 9/4/2009 12:59 PM (GMT -8)
wow!  I am surprised they had you start with .3 as that is what I started with and ended up with a 6 hour erection.  I seem now to be having great results with levitra for the last month and am doing real well with it.
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Piano
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Joined : Apr 2008
Posts : 847
Posted 9/4/2009 2:06 PM (GMT -8)
TKKNZ_GRANDPA: welcome to the forum.

If you are using Trimix, I too would be very cautious about raising the dose. A few other things to try first, maybe even with a reduced dose:

You didn't mention massage after the injection -- I do that and plenty of it. Standing up may be better as it raises the blood pressure, and I do Kegels as well. Also some rubber bands wrapped around the base of the penis before and for about three minutes after injection do me no harm :-)
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